An artist’s rendition of SARS-CoV-2 viruses magnified/Wikimedia Commons

In the overall scheme of life, Alaska came through the first wave of the global pandemic basically untouched, according to a June summary from the state Division of Public Health.

The agency’s “Excess deaths associated with COVID-19, Alaska, January – May 2020” report recorded an increase of only three deaths over and above the 2017-2019 average for these months, and those three deaths are lost in the annual variation of 171 deaths over the previous three years.

Past deaths ranged from a high of 1,980 last year to a low of 1,809 in 2017, according to the report, which has gone largely unreported as most of the news in the 49th state has focused on a second wave of infections and death.

COVID-19 cases have blossomed across Alaska since the end of May with daily counts of new infections now more than double the March 23 peak of 17. Anchorage alone reported more infections on July 2 then the entire state witnessed at the start of the pandemic, and when the 21 infections in the state’s largest city were added to the statewide total it reached 44.

Part of the increase is due to expanded testing. Daily tests have increased from fewer than 900 back in March to a peak approaching 3,500. As the number of tests has gone up, the number of positives has generally gone down although there was a slight increase in the rate in late June.

More than 4 percent of those tested in early April turned up positive. The number is now down to about 1.5 percent, but with more than triple the number of people being tested the total number of positive cases has gone up significantly.

Still, it’s way below what it might be. If 4 percent of tests were still coming back positive, the state would have been looking at about 140 new cases Thursday – about three times the number found.

How many undiagnosed cases there are in the state remains an unknown, but four months into the pandemic it is clear that SARS-CoV-2, the virus responsible for COVID-19, attacks people in different ways.

Some can be infected and not even know it given they suffer no symptoms. Others get mild symptoms that could be mistaken for a simple upset stomach.  Some suffer a flu-like sickness. Others are nearly disabled. Some need to be hospitalized. And too many die.

The global death count as of today is approaching 531,000 according to Worldometer tracking. Almost a quarter of those deaths have come in the U.S. where the states in the Northeast have been hard hit.

New Jersey has the highest death rate in the world with 171 of every 100,000 residents falling victim to COVID-19, but New York, Connecticut and Massachusetts are not far behind. 

The Massachusetts death rate of 118 per 100,000 is more than 13 times the rate of Texas, 12 times the rate of Florida and more than seven times the rate of Arizona – all states which has been recently in the news because of breakouts out of COVID-19. 

The situation in Alaska is tame by comparison. The state death rate of 21 per 100,000 is less than a fourth of the 90 per 100,000 rate in Texas, and the known Alaska infection rate of  1,453 cases per 100,000 is less than 7 percent of the rate in New York which has now reached a staggering 21,663 cases per 100,000 people, according to Worldometer.

Catch it if you want

But the virus is prevalent enough in the 49th state to make it catchable if you try.

The Municipality of Anchorage on Friday released a list of businesses linked to newly diagnosed cases of COVID-19. Most, but not all, were bars. Some had reputations as smoke-filled bars before smoking was banned in Anchorage drinking establishments.

The list of businesses and the expected dates of exposure can be found here: “Confirmed COVID-19 Exposure Locations.”

The city is suggesting that if you were in any of listed locations on the associated dates you should stay away from those most vulnerable to death from COVID-19, mainly the elderly and people with diabetes, cancer, heart, lung or other chronic diseases; closely monitor your health, including a check of your temperature twice per day; and get tested for COVID if you find you have a fever, develop symptoms of what appears to be a cold or upset stomach, or lose your sense of smell or taste.

Anchorage Mayor Ethan Berkowitz has ordered everyone to wear face coverings in businesses in Anchorage in hopes of slowing the latest spread of the disease, but how well face masks work remains an unknown.

The best advice to those especially vulnerable to COVID-19 – primarily people over 50 and/or suffering from a chronic disease – is to stay 6 feet away or more (preferably more) from others and studiously avoid poorly ventilated spaces.

Cigarette smoke accumulation was once a good indication of how well a business’s ventilation system was working. Anchorage residents familiar with those old bars might want to avoid some on the muni list with a known history of filling with smoke.

Or avoid all indoor drinking and eating spaces. Outdoor dining or drinking at tables separated by at least six feet is considered safest by the Centers for Disease Control (CDC). 

Fresh air and high rates of ventilation have been known to be protective against infectious respiratory diseases since the Spanish flu killed an estimated 675,000 Americans more than 100 years ago.

U.S. deaths from COVID-19 to date number just over 132,000. For comparison sake, if the Spanish flu death rate of approximately 637 per 100,000 were applied to the U.S. population of today, which is about three times larger than during the Spanish flu, the death toll would pass 2 million.

Nationally, the U.S. death rate for COVID-19 now stands at 40 per 100,000. Outside of the Northeast states, the disease is not is deadly as it is sometimes portrayed.

But if you want to maximize your chances of catching it, spend a lot of time with crowds in poorly ventilated spaces, engage them in closing-talking conversations, and maybe even share drinks with them.

Scientists still aren’t absolutely sure of the main way in which the virus spreads, but droplets emitted when you exhale or speak, aerosols from your breathe, and direct human-to-human contact have all been implicated.

A safer world

One apparent conclusion that can be drawn from the state’s report on “Excess deaths associated with COVID-19, Alaska, January – May 2020″ is that we are generally safer – at least in the short term – when government officials restrict the movements of the citizenry.

Because of the threat of spreading the SARS-CoV-2 virus, Alaska Gov. Mike Dunleavy on March 18 ordered a closure of bars, restaurants, theatres, gyms, bingo halls and more which significantly reduced the reasons for people to leave their homes. 

Ten days later he ordered the closure of all “non-essential businesses” and said “all persons in Alaska, except for those engaged in essential health care services, public government services, and essential business activities” were to stay home. 

Traffic on Alaska roads and highways dropped to a trickle as unemployment grew among the commuter crowd and those able to work online turned to their computers. The change is now reflected in the data.

Traffic fatalities for January to May 2020 dropped 34 percent from the average and with only 23 deaths were well below the number for the lowest previous year – 29 in 2018. Deaths from unintentional injuries also fell as did those from homicide, cancer and respiratory diseases in general.

Even suicides – despite concerns about the psychological consequences of the lockdown – fell from an average of 81 for the period to 69.

In fact, the only category of death that went up – aside from COVID-19 which was all new – was for heart disease, long a major killer in the state. Deaths there increased from an average of 330 for the period to 343, the largest number in the past four years.

Cancer and heart disease are the state’s two big killers. They claim the lives of more than 100 per 100,000 Alaskans almost every year. That is about 4.5 times the Alaska death rate for COVID-19 at this time, though the COVID-19 rate is sure to increase before the year is over.

All of these death rates could be reduced, physicians contend, if Alaskans paid more attention to the lifestyle issues of diet and exercise.

Dr. Zhan Yan, the director of the Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center at the University of Virginia has linked cardiovascular exercise to an increase in extracellular superoxide dismutase (EcSOD), a potent antioxidant that appears protective against COVID-19.

Medical research findings now “strongly support” the possibility that EcSOD can prevent or reduce the severity of acute respiratory distress syndrome (ARDS), according to UVA Today. 

ARDS is one of the main ways COVID-19 kills. Sixty-seven to 85 percent of the COVID-19 patients who end up in intensive care units are there because of the risk of dying from ARDS, according to the CDC. 

“All you hear now is either social distancing or ventilator, as if all we can do is either avoid exposure or rely on a ventilator to survive if we get infected,” Yan told UVA. “The flip side of the story is that approximately 80 percent of confirmed COVID-19 patients have mild symptoms with no need of respiratory support. The question is, ‘Why?’ Our findings about an endogenous antioxidant enzyme provide important clues and have intrigued us to develop a novel therapeutic for ARDS caused by COVID-19.”

Yan admitted to being a proponent of exercise, telling the university publication that “we cannot live in isolation forever. Regular exercise has far more health benefits than we know. The protection against this severe respiratory disease condition is just one of the many examples.”

Many of the other examples have been known for a long time. Unfortunately, the ease of life in the 21st Century and the internet, which encourages people to sit at computers, has led to reduced exercise levels, and COVID-19 doesn’t appear to be helping.

Researchers who studied daily step counts of people who use Apple and Android phones to track their daily step counts found activity levels dropped at the start of the pandemic and have remained depressed.

Writing in the Annals of Internal Medicine, the researchers reported tracking more than 19 million step-count measurements “provided by 455,404 unique users from 187 unique countries during the (Jan. 19 to June 1) study period.

“Worldwide, within 10 days of the pandemic declaration, there was a 5.5 percent decrease in mean steps (287 steps), and within 30 days, there was a 27.3 percent decrease in mean steps (1432 steps)….

“The effect of social distancing measures on overall physical activity, an important determinant of health, should be considered, particularly if prolonged social distancing is required,” they warned.

Other researchers have similarly warned that people retreating from life to hide from COVID-19 could result in other unintended consequences for health. A “stark dip” in cancer screening has been reported since the pandemic began. Millions of children around the globe have missed vaccinations. 

And the mental health burdens of worry, isolation and job loss are growing by the day, according to the Kaiser Family Foundation, a national non-profit organization focused on U.S. health care.

Some of the consequences of these behavioral changes are likely to pop up in future state death reports.

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